The National Community Pharmacists Association (NCPA) has sent a letter to Congressional leaders, representing a coalition of 134 organizations that include patient groups, health care providers, employers, business groups, and union workers. The letter urges Congress to pass pharmacy benefit manager (PBM) reform before the end of the year.
"The American public is tired of losing access to their local health care providers and of paying too much out-of-pocket for the medicines they need," said the groups. Pharmacists are some of the most accessible and trusted health care professionals in America, with patients—particularly in rural and underserved communities—reliant on their training and expertise."
The coalition's letter was addressed to House Speaker Mike Johnson (R-La.), Senate Majority Leader John Thune (R-S.D.), House Minority Leader Hakeem Jeffries (D-N.Y.), and Senate Minority Leader Chuck Schumer (D-N.Y.). It calls for passage of the PBM Reform Act (H.R. 4317), as well as two companion bills in the Senate: the Protecting Pharmacies in Medicaid Act (S. 927) and the Patients Before Middlemen Act (S. 882).
"All of these measures have bipartisan support in both houses," said NCPA CEO B. Douglas Hoey. "Everyone in Washington sees what's happening and everyone outside the beltway is feeling the pain from PBM business practices. Everyone knows the PBMs are overcharging taxpayers, driving up drug prices, and reducing patient access to life-saving drugs. We're very proud to have worked with all these groups to make it unmistakably clear to Congress that these reforms can be delayed no longer."
The proposed legislation aims to ban spread pricing in Medicaid—a practice where PBMs charge state prescription programs more than they reimburse pharmacies—resulting in significant costs for states. The bills would also require fairer contract terms between PBMs and pharmacies under Medicare Part D, prevent anti-competitive payment practices, delink drug prices from PBM revenues, ensure negotiated savings are passed directly to employers and workers, and increase price transparency through regular reporting on prescription drug spending.
"These all support the same underlying goal—to address the PBMs anti-competitive, anti-consumer practices," say the groups. "These provisions received overwhelming support in both parties and in both chambers of Congress. By enacting these measures, you can deliver relief to patients and families at their local pharmacy counter, employers facing continued increases in health care costs, and taxpayers who are currently overpaying for government-provided benefit programs."
According to data cited by the coalition from the Federal Trade Commission, PBMs earned more than $7 billion between 2017 and 2022 by up charging specialty generic drugs. During this period, one-third of retail pharmacies have closed since 2010—a trend that has increased so-called pharmacy deserts across parts of the country.
"We urge you to prioritize PBM reform this fall and ensure these bipartisan efforts are enacted into law without delay," says the letter. "Immediate action is needed to address these harmful practices. Americans deserve and expect protection from inflated prescription drug costs, from forced pharmacy closures, and from barriers to their pharmacy of choice that result from PBM tactics."
More information about NCPA can be found at www.ncpa.org.
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